ACE inhibitor ( s)n. Angiotensin-converting enzyme inhibitor; any of a class of drugs that reduce peripheral arterial resistance by inactivating an enzyme that converts angiotensin I to the vasoconstrictor angiotensin II, used in the treatment of hypertension, congestive heart failure, and other cardiovascular disorders. |
Angiotensin-converting enzyme (ACE) inhibitor
A drug that relaxes blood vessel walls and lowers blood pressure.
Mentioned in: Congestive Cardiomyopathy, Heart Failure
ACE inhibitor
Angiotensin-converting enzyme inhibitor Pharmacology Any of a family of drugs that are used to manage essential HTN, ↓ CHF-related M&M Pros ACEIs are cardioprotective and vasculoprotective; cardioprotective
effects include improved hemodynamics and electric stability, ↓ SNS activity and ↓ left ventricular mass; vasculoprotective benefits include improved endothelial function, vascular compliance and tone, and direct antiproliferative and
antiplatelet effects; ACEIs also stimulate PG synthesis, ↓ the size of MIs, ↓ reperfusion injury and complex ventricular arrhythmias; ACEIs are the treatment of choice in CHF with systolic dysfunction; they are vasodilators which ↓
preload and afterload; ACEI-induced ↓ in angiotensin II inhibits the release of aldosterone, which in turn ↓ sodium and water retention which, by extension, ↓ preload; ACEIs improve hemodynamics of CHF by ↓ right atrial pressure,
pulmonary capillary wedge pressure, arterial BP, as well as pulmonary and systemic vascular resistances; ACEIs ↑ cardiac and stroke indices by the left ventricle and ↓ the right ventricular end-diastolic volumes, thereby resulting in
↑ cardiac output, while simultaneously ↓ cardiac load and myocardial O2 consumption; ACEIs also downregulate the SNS, which is linked to the pathogenesis of CHF Adverse effects Idiopathic–eg, rashes, dysgeusia, BM
suppression; class-specific–eg, hypotension, renal impairment, hyperkalemia, cough, angioneurotic edema, the latter 2 of which are mediated by small vasoactive substances, eg, bradykinin, substance P, and PG-related factors
ACE inhibitor Effects in Heart Disease
Cardioprotective effects
- Restores balance between myocardial O2 supply & demand
- Reduces left ventricular preload and afterload
- Reduces left ventricular mass
- Reduces sympathetic stimulation
Vasculoprotective effects
- Antiproliferative & antimigratory effects on smooth muscle & inflammatory cells
- Antiplatelet effects
- Improved arterial compliance and tone
- Improved and or restored endothelial function
- Antihypertensive
- Possibly, antiatherosclerotic effect
After Lonn et al, 1994
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